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孤立性髓内脊髓Rosai-Dorfman病:一例报告及文献复习

Isolated Intramedullary Spinal Rosai-Dorfman Disease: A Case Report and Literature Review.

作者信息

Huang Bo Yuan, Liu Hai Long, Yu Chun Jiang

机构信息

Department of Neurosurgery, San Bo Brain Hospital, Capital Medical University, Beijing, China.

Department of Neurosurgery, San Bo Brain Hospital, Capital Medical University, Beijing, China.

出版信息

World Neurosurg. 2016 Apr;88:694.e11-694.e15. doi: 10.1016/j.wneu.2015.12.074. Epub 2015 Dec 31.

Abstract

BACKGROUND

Rosai-Dorfman disease (RDD) is a rare histioproliferative disorder that only occasionally involves the central nervous system.

CASE DESCRIPTION

We present the diagnosis and treatment of an exceedingly rare case of isolated intramedullary spinal RDD that has been reported only 3 times previously. Moreover, it is the first time that intramedullary spinal RDD has been described in a child. The patient was treated by total surgical resection and experienced no recurrence during the 12-month follow-up. Histopathologic examination showed a characteristic emperipolesis; the lymphocytes were engulfed in the S-100-protein-positive histiocytes with negative expression of CD1a.

CONCLUSIONS

Preoperative diagnosis of spinal RDD is still challenging because the lesion usually is a dura-based lesion that mimics a meningioma. Surgical resection is an effective treatment and radiotherapy; and steroid and chemotherapy have not demonstrated reliable therapeutic efficiency.

摘要

背景

罗萨伊-多夫曼病(RDD)是一种罕见的组织细胞增生性疾病,仅偶尔累及中枢神经系统。

病例描述

我们报告了一例极其罕见的孤立性脊髓内RDD的诊断和治疗情况,此前仅报道过3次。此外,这是首次在儿童中描述脊髓内RDD。该患者接受了全手术切除治疗,在12个月的随访期间未复发。组织病理学检查显示特征性的嗜组织细胞现象;淋巴细胞被S-100蛋白阳性组织细胞吞噬,CD1a表达阴性。

结论

脊髓RDD的术前诊断仍然具有挑战性,因为病变通常是硬膜源性病变,类似于脑膜瘤。手术切除是一种有效的治疗方法,而放疗、类固醇和化疗尚未显示出可靠的治疗效果。

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